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Three-Dimensional CT Texture Analysis to Differentiate Colorectal Signet-Ring Cell Carcinoma and Adenocarcinoma

Authors Yue Y, Hu F, Hu T, Sun Y, Tong T, Gu Y

Received 6 October 2019

Accepted for publication 19 November 2019

Published 13 December 2019 Volume 2019:11 Pages 10445—10453

DOI https://doi.org/10.2147/CMAR.S233595

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Rudolph Navari


Yali Yue,* Feixiang Hu,* Tingdan Hu, Yiqun Sun, Tong Tong, Yajia Gu

Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yajia Gu; Tong Tong
Department of Radiology, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Shanghai 200032, People’s Republic of China
Tel +8618121299466
; +8617349786369
Fax +862164174774
Email cjr.guyajia@vip.163.com; t983352@126.com

Purpose: The objective of this research was to validate the diagnostic value of three-dimensional texture parameters and clinical characteristics in the differentiation of colorectal signet-ring cell carcinoma (SRCC) and adenocarcinoma (AC).
Methods: We retrospectively analyzed data from 102 patients with SRCC or AC confirmed by pathology, including 51 SRCC (from January 2015 to July 2019) and 51 AC patients (from January 2019 to July 2019). CT findings and clinical data, including age, gender, clinical symptoms, serological biomarkers, tumor size, and tumor location, were compared between SRCC and AC. CT texture features were quantified on portal phase images using three-dimensional analysis. A list of texture parameters was generated with MaZda software for the classification of tumors. The texture features, clinical data and CT findings were statistically analyzed for the discrimination ability of SRCC and AC, and the potential predictive parameters that may be used to differentiate the two groups were subsequently tested using the least absolute shrinkage and selection operator (LASSO) and logistic regression analyses. The receiver operating characteristic curve (ROC) provided a range of values for establishing the cutoff value, as well as the sensitivity and specificity of prediction for each significant variable.
Results: SRCC occurred more often in men than AC did (80.39% vs 49.02%, P < 0.01). The patients were younger in the SRCC group than in the AC group, without a statistically significant difference (55.84 vs 59.20 years, P = 0.216). There were no significant differences in the clinical symptoms, tumor size, or tumor location between the two groups (P=0.505, P=0.19, P=0.843, respectively). The elevation of serological biomarker CA724 was more common in SRCC than in AC (P< 0.001). Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg were lower in the SRCC group than in the AC group during the portal phase, with the areas under curve (AUCs) of 0.892–0.929, sensitivity of 76.5–84.3% and specificity of 88.2–96.1%. In the differentiation between SRCC and AC, the 1-NN minimal classification error (MCR) was 29.41%.
Conclusion: Three-dimensional texture parameters, including Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg, exhibited a favorable discriminatory ability to distinguish SRCC from AC.

Keywords: computed tomography, colorectal signet-ring cell carcinoma, adenocarcinoma, texture analysis, three-dimensional

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